We improve mobility and activity for individuals living with complex movement challenges through the intentional integration of clinically driven research with education, training and care.
At Parkwood Institute, rehabilitation is more than a phase of care it’s where recovery begins. Here, patients facing stroke, spinal cord injury, chronic pain, and other mobility-limiting conditions receive some of the most specialized rehabilitation care in the country. The teams are skilled. The outcomes are strong But even with all that, we know there’s always more we can do.
That’s where the Gray Centre for Mobility and Activity comes in. As Parkwood Institute’s clinical mobility and activity research centre, we exists to take what’s already working and make it even better It brings together clinicians, scientists, and people with lived experience to develop and test new approaches that help more people move, recover, and live independently.
The Gray Centre is made possible through a generous philanthropic gift to St. Joseph’s Health Care Foundation from William and Lynne Gray
This work spans everything from real-time analysis of brain activity in stroke patients, to fall prevention clinics, to hands-on collaborations that connect research directly with patients and frontline care. It’s not research for the sake of knowledge it’s research designed to solve problems, close gaps, and make care more effective.
You’ll see many of these innovations reflected in the pages that follow all highlights of what we’ve accomplished since January 2024. From adaptive fitness programs expanding into the community, to the installation of cutting-edge technology, to collaborative workshops that bridge institutions, to trainee-led projects centered on people with lived experience the Gray Centre is turning ideas into action.
This year marked a major milestone for the Gray Centre for Mobility and Activity with the installation of Canada’s only operational FLOAT system at Parkwood Institute a ceiling-mounted, body-weight support device that enables patients to move safely and freely in all directions during rehabilitation.
Developed in Switzerland, FLOAT allows for three-dimensional, natural movement and responds in real time to patient motion. It supports recovery for individuals with stroke, spinal cord injury, and other mobility challenges by reducing fear of falling and promoting confidence and independence.
FLOAT also serves as a powerful research platform. When integrated with advanced technologies like electromyography and functional near-infrared spectroscopy, it enables researchers to collect detailed data on movement and brain activity during therapy.
“The FLOAT is an absolute gamechanger for our patients!” Dennis Argoso Physical Therapy Assistant Parkwood Institute
For many Ontarians, the high cost of medical equipment and assistive devices creates a serious barrier to recovery, discharge, and independent living particularly for those without insurance or financial support. At the same time, usable equipment often goes unused or ends up in landfills.
Launched in 2023, the Possibilities Project Plus addresses both challenges by connecting people who wish to donate gently used medical and assistive equipment with individuals who need them. As an official affiliate of St. Joseph’s, the program is fully integrated into hospital operations through collaboration with clinical teams and care coordinators
With support from researchers, clinicians, and trainees, the program ensures a streamlined, sustainable donation process that improves access, promotes environmental responsibility, and helps people transition home safely. Since its inception, more than 100 devices have been redistributed across London and the surrounding region.
“Thank you to Possibilities for my mattress and bed. It is wonderful and is giving me a better quality of sleep. I cannot express enough how much I appreciate your generous gift” – London community member
For many patients, the transition from inpatient rehabilitation back to community life is filled with both visible and invisible challenges. Yet these experiences are often underrepresented in clinical and research settings.
To help change that, Dr. Janelle Unger hosted a powerful photo gallery event at Parkwood Institute on June 26, 2024, highlighting the real-life journeys of former patients following discharge. The gallery featured 23 photographs, each paired with personal reflections on the enablers and barriers encountered during reintegration. Several participants also gave live presentations, sharing stories of resilience, adaptation, and advocacy.
The event sparked meaningful conversations among attendees patients, staff, and researchers alike and served as a reminder that lived experience should play a central role in shaping rehabilitation care and policy.
“This used to be an accessible parking spot, which was close the mall entrance. Why can’t charging stations be located at the back of a parking lot?”
“I’m back in my backyard where my dog is sniffing the flowers. She enjoys the flowers”
“The stairs look like Mt. Everest!”
“As a community based organization and charity with a mission to serve and support people of all ages, backgrounds and abilities, the YMCA of Southwestern Ontario is incredibly proud and excited to work with another organization that shares our values and mission in St. Joseph's Health Care London”
Ash De Cruz Regional Manager YMCA of Southwestern Ontario
The Parkwood Institute Fitness Centre (Fitness Centre) has long supported individuals with chronic mobility impairments and physical disabilities through adaptive, guided physical activity programs that promote strength, mobility, and well-being. These programs help participants stay active, maintain independence, and improve quality of life. For many, the Fitness Centre offers a vital next step after discharge from Parkwood’s outpatient clinical programs helping them maintain progress and stay engaged in their recovery. However, demand for the Fitness Centre has grown steadily and it is now operating at full capacity. To address this pressure, we launched a pilot project with the YMCA of Southwestern Ontario.
Based at the downtown Centre Branch location, our organizations partnered to introduce two adaptive fitness classes that have created new opportunities for inclusive, community-based exercise programming. Designed as a model for future programming, the pilot brought together YMCA instructors and rehabilitation specialists to tailor classes for participants with diverse physical abilities ensuring safety, engagement, and progress.
We’re grateful to the YMCA team for their partnership and shared commitment to inclusive health Together, we’re building stronger pathways from rehabilitation to community life one class at a time.
Falls are the leading cause of injury-related ho death among older adults in Canada, often r altering trauma for individuals and families health system billions of dollars each year. population rapidly growing, this issue is escala in Southwestern Ontario, where both the pop demographics are rapidly increasing. Many of involve repeat fallers and have underlying med require more than environmental fixes.
To address this, Parkwood Institute has laun Clinic (Falls, Fractures, Frailty, and Mobility Jaspreet Bhangu and Janelle Unger core m Gray Centre for Mobility and Activity. Th together an interdisciplinary team with exp rehabilitation, and fall prevention. Patien thorough geriatric assessment to identify phy and medical contributors to fall risk, with care their specific needs.
In parallel, the clinic is advancing applied research to better understand and predict fall risk. With support from the Gray Centre, the team uses advanced technologies such as an instrumented gait mat and wearable sensors to collect highresolution data on balance, walking speed, and step variability. These data are being used to develop and refine predictive models that can inform more personalized interventions contributing not only to better care at Parkwood Institute, but to a broader evidence base that supports fall prevention in homes, clinics, and long-term care settings.
"This clinic combines expert care with leading-edge research helping us prevent falls more effectively and improve outcomes for older adults."
Erin Watson Clinical Director of Specialized Geriatric Services Parkwood Institute
“I am very proud to be a part of Parkwood, a Rehabilitation Center of Excellence that brings together compassionate care with important research. It’s an honor to work alongside our rehabilitation teams and physicians like Dr. Fleet who are not only leaders in the field but also passionately committed to optimizing rehabilitation and recovery.”
Rebecca Fleck
of Rehabilitation, Parkwood Institute
A recent award-winning research paper led by Dr. Jamie Fleet addressed a simple but critical question – What is the optimal amount of rehabilitation needed to maximize stroke recovery without overburdening patients and the healthcare system? Dr. Fleet and her team analyzed data from over 12,000 stroke patients in Ontario to find that while increased rehabilitation intensity leads to better outcomes, the benefits plateau after around 95 minutes of daily therapy far below the 180 minutes currently recommended. The implications of this research on patient care are significant. Adopting a more focused approach to stroke rehabilitation intensity should lead to more efficient, tailored therapy that improves patient outcomes and quality of life without overextending resources. This study opens the door to reconsider current practices, suggesting that a more sustainable and efficient model of care might be possible without comprising the health outcomes of those who have suffered a stroke.
Chronic pain is a leading cause of disability worldwide, and one of the strongest predictors of who will develop it is how much pain a person experiences early on after injury or surgery. But until now, there’s been no reliable way to identify who is more sensitive to pain before it becomes a problem A recent study led by Dr. Siobhan Schabrun’s research team has shown that a novel brain-based biomarker signature can accurately predict individual pain sensitivity. By measuring brainwave activity and motor system responsiveness, the team was able to distinguish high- from low-sensitivity individuals in a prolonged pain model involving 150 participants Because early intense pain is closely linked to the development of chronic pain, this biomarker could help flag those at higher risk paving the way for more proactive, personalized pain management.
“This breakthrough brainbased biomarker offers a promising tool to predict individual pain sensitivity before chronic pain sets in. By enabling earlier, more personalized interventions, it has the potential to transform pain management and reduce long-term suffering for countless patients.”
Dr. Eldon Loh
Physiatrist & Earl Russell Research Chair in Pain Management Director
Thuvaraha Jeyakumaran joined the Research 2 Practice team in 2023 as a research coordinator and knowledge mobilization specialist, following her graduate studies in global health systems at Western University. She first connected with the team through a work-study placement and quickly stood out for her ability to bridge research with real-world impact.
Thuvaraha has since earned recognition for her leadership in codesigning research with people who have lived experience Most recently, she received the Early-Career Scholar Award for her poster presented at the International Spinal Cord Society conference, taking place in Antwerp in the fall of 2024. This marked her third research award within the past year, following previous honours for presentations in London and Atlanta.
Her most recent project explores how co-design shaped a clinical trial on intermittent fasting for individuals living with chronic pain and depression. In this work, people with lived experience helped d fi it t t t i d ll b ted with students from Western to develop a participant-
Arden Lawson recently completed her MSc in the Neuroscience graduate program at Western University, where she led the world’s first clinical trial investigating vagus nerve stimulation in individuals with spinal cord injury Her study produced critical safety and efficacy data, marking a major step forward in neurorehabilitation research. Alongside her thesis work, Arden serves as lead research coordinator at the Parkwood Rehabilitation Clinical Research Unit, having supported clinicians and researchers in over 30 clinical trials across a range of rehabilitation topics.
Arden’s research excellence has earned her multiple accolades, including the Siskinds Studentship in Spinal Cord Injury award and a recent nomination for the prestigious Governor General’s Gold Medal Award. She has also been accepted into the highly competitive MD program at the Schulich School of Medicine & Dentistry at Western University, beginning in the fall of 2025, an achievement that reflects her outstanding academic record, leadership, and unwavering commitment to advancing patient care.
The Gray Centre’s Coffee Lunches are reoccurring Friday events at Parkwood Institute that bring researchers and clinicians into a shared space to learn with and from each other. These informal gatherings encourage crossdisciplinary exchange, often sparked by short talks from invited speakers. Thanks to all our presenters for sharing their insights we look forward to more engaging conversations in the months and years ahead.
On March 4, 2024 the Gray Centre welcomed former federal MP Lindsay Mathyssen, along with leaders from St. Joseph’s, LHSC, and Lawson, to highlight how clinical research is advancing care for Canadians.
Demonstrations included non-invasive brain stimulation for chronic pain, electrical stimulation for spinal cord injury, and fall prevention in older adults. The visit wrapped with a discussion on the importance of federal investment in health research.
To strengthen collaboration in spinal cord injury (SCI) research, the Gray Centre hosted a workshop on June 23, 2025, bringing together 17 researchers, clinicians, administrators, and people with lived experience from across London’s institutions. Participants identified shared priorities and laid the groundwork for a sustainable research network and projects to be tackled together in the near future.
“This event laid the groundwork for a more unified and impactful research effort in London I am excited about the momentum it has created and the opportunities it creates for meaningful, patient-centered progress” - Saagar Walia, Parkwood SCI Inpatient Clinical Manager
Assessing bone health and body composition is essential for understanding and managing conditions that affect mobility, such as osteoporosis, sarcopenia, and frailty. Yet, until now, patients at Parkwood Institute have lacked convenient access to this vital diagnostic technology, creating a significant gap in clinical care.
To address this, the Gray Centre for Mobility and Activity is preparing to install a state-ofthe-art Dual-energy X-ray Absorptiometry (DXA) scanner, expected to be operational in early 2026.
This versatile machine will enable precise measurement of bone mineral density, muscle mass, and fat composition supporting both clinical assessment and research.
The on-site DXA will empower clinicians to better identify and manage mobility-related conditions while providing researchers with a critical tool to study bone and muscle health across diverse populations. This will help close important knowledge gaps around conditions like post-stroke osteoporosis and muscle loss, ultimately contributing to improved outcomes and quality of life for patients.
“Bringing DXA to Parkwood Institute fills a critical gap—enhancing patient care today and unlocking new research possibilities for tomorrow”
Stephen Nelli Clinical Director Medical Imaging and
Breast Care
St. Joseph’s Health Care London
One way our physicians help relieve lower back pain is through a procedure called radiofrequency ablation, which uses heat to safely interrupt pain signals from nerves in the spine. It’s an effective treatment that can offer long-lasting relief for people who haven’t found success with other options.
Now, the Gray Centre for Mobility and Activity is preparing to take the next step. We’re working toward acquiring a High Intensity Focused Ultrasound (HIFU) device — a new, non-invasive technology that uses precisely targeted sound waves to target the same nerves as radiofrequency ablation, but with even greater precision and the potential for better outcomes. Unlike traditional ablation, HIFU doesn’t require needles or incisions, which also means faster recovery and fewer risks for patients.
If successful, this will make St. Joseph’s one of the first sites in North America to use HIFU clinically for back pain The device will be used within the Pain Clinic and play a central role in future research, putting us at the forefront of both care delivery and innovation in pain management.
“This technology will allow us to target spinal areas contributing to chronic low back pain without needles or anesthesia. It also allows us to offer our community a novel, image-guided treatment at a time when painrelated conditions are among the top health burdens in Southwestern Ontario. By integrating this technology, we not only expand options for care, but also advance research in non-invasive spinal interventions”
Dr. Geoff Bellingham
Medical Director
St. Joseph’s Chronic Pain Clinic
Since its inception, the Gray Centre for Mobility and Activity has become a recognized leader in rehabilitation research. Our talented and dedicated team of physiatrists, geriatricians, therapists and scientists work to improve mobility and function in adults through interdisciplinary collaboration, technological innovation, and the rapid translation of research into practice Over the past 18 months, we’ve produced new insights and advancements across multiple domains. All publications and quick summaries from this period are listed below. Names in bold are core Gray Centre researchers and names in italics represent research fellows, trainees, or staff.
Fleet J.L., Kapral M.K., Carter B., Frisbee S., Lam M., Shariff S.Z. Secondary stroke prevention in Ontario: a population based cohort study. Canadian Journal of Neurological Sciences
This studyevaluated secondarystroke prevention care in Ontario, Canada, using health administrative data from 2010 to 2019 Among 54,712 ischemic stroke survivors, most saw a general practitionerwithin 90 days post-discharge, but fewerreceived recommended lab tests orinfluenzavaccinations Medication usewas high among those over65,yet overall adherence to prevention guidelineswas suboptimal
Fleet J L , Carter B , Kapral M K , Lam M , Frisbee S , Shaiff S Z Post TIA care in Ontario: A population-based cohort study on secondary prevention Journal of the Neurological Sciences
This studyfound that manypeoplewho experience a transient ischemic attack (TIA) do not receive important follow-up tests ortreatments to reduce theirrisk of future stroke Compared to individualswho had a stroke, thosewith aTIAwere less likelyto receive diabetes testing orbe prescribed keyprevention medications
George C M , Dabbagh A , Unger J , Babatunde F, MacDermid J C Quality of life measures for people following stroke: a structured content review Quality of Life Research
This review analyzed the content of three commonlyused stroke-specific qualityof life measures bymapping theiritems to the International Classification of Functioning, Disabilityand Health (ICF) framework The studyfound that while these tools covervarious aspects of health, theydifferin focus, suggesting that clinicians should select measures alignedwith individual patient goals
Knight S., Swance R., Bateman E.A., Clemens K.K., Papaioannou A., Fleet J.L. Post-stroke osteoporosis screening: A scoping review. Cerebrovascular Diseases
This scoping review found that osteoporosis screening afterstroke is rarelyperformed,with reported rates under10% Despite the known fracture risk, no screening guidelines currentlyexist forthis population The findings highlight the need fortargeted post-stroke osteoporosis screening protocols and tools
MacDonald S.L., Linkewich E., Bayley M., Jeong I.J.H., Fang J., Peters S., Fleet J.L. Males receive more intense inpatient stroke rehabilitation than females in Ontario, Canada. Canadian Journal of Neurological Sciences
This studyfound that males under80 in Ontario received more intensive inpatient stroke rehabilitation than females,with longerdailytherapytimes The results point to a s ex-based gap in stroke care delivery
MacDonald S L , Linkewich E , Bayley M , Jeong I J H , Fang J , Fleet J.L. The association between inpatient rehabilitation intensity and outcomes after stroke in Ontario, Canada International Journal of Stroke
This studyshowed that higherrehabilitation intensityafterstroke improves functional recovery,with benefits leveling off afterabout 95 minutes perday
McIntyre A , Teasell R , Saikaley M , Miller T Predictors of spasticity 3-6 mos after stroke: A 5-yr retrospective cohort study
American Journal of Physical Medicine and Rehabilitation
This studyfound that 20% of stroke patients developed spasticitywithin 3–6 months,with higherrisk linked to hemorrhagic stroke,youngerage, hemiplegia, familyhistory of stroke, lowerfunctional scores at admission, and SSRI use.These factors can help clinicians identifypatients needing closerfollow-up afterdischarge.
MacKenzie H.M., Viana R. Constraint-induced therapies. Ischemic Stroke Therapeutics: A Comprehensive Guide
This chapterreviews constraint-induced movement therapy(CIMT) forstroke rehabilitation, highlighting both traditional and modified protocols It explores CIMT’s use across all recoveryphases and discusses barriers and alternative deliverymethods to improve accessibility
Mehrabi S., Cameron L., Bowman A., Fleet J.L., Eng J., Bayley M.T., Teasell R. A systematic review of female participation in randomized controlled trials of post-stroke upper extremity rehabilitation in low- to middle-income countries and high-income countries and regions. Cerebrovascular Diseases
This systematic review found that women remain underrepresented in randomized controlled trials of post-stroke upperextremityrehabilitation, comprising only36 9% of participants in low- to middle-income countries and 39 5% in high-income countries Despite regional differences, female enrollment has not improved overthe past two decades, highlighting a persistent gap in trial representation
Mehrabi S., Fleet J.L., Safaei-Qomi M.R.; Dukelow S.P., Murie-Fernandez M., Harnett A., Teasell R. Systematic review of upper extremity outcome measures assessed in randomized controlled trials of poststroke upper extremity rehabilitation in low-to-middleincome and high-income countries Archives of Physical Medicine and Rehabilitation
This review showed that randomized controlled trials in low-to-middle-income countries (LMICs) and high-income countries (HICs) differsignificantlyin theirchoice of outcome measures forpoststroke upperextremityrehabilitation These differences likelyreflectvariations in resources, expertise, and practical constraints, highlighting the need to considerlocal context when selecting outcome measures in stroke research
Mehrabi S , Flores-Sandoval C , Fleet J L , Cameron L , Teasell R Comparing interventions used in randomized controlled trials of upper extremity motor rehabilitation post-stroke in high-income countries and low-to-middle-income countries Archives of Physical Medicine and Rehabilitation
This studyfound that high-income countries more often used robotics and task-specific training in upperextremitystroke rehabilitation trials,while low- to middle-income countries favored acupuncture and rTMS These differences reflectvariations in resource availabilityand clinical infrastructure
Mehrabi S., Flores-Sandoval C., Teasell R., MacKenzie H.M., Kurian M., Bateman E.A. An overview of randomized controlled trials examining prescription and nonprescription pharmacological interventions for moderate to severe traumatic brain injury. Journal of Pharmacy Technology
This systematic review analyzed 313 randomized controlled trials on pharmacological interventions formoderate to severe traumatic brain injury, identifying 146 unique therapies,with mannitol being the most frequentlystudied However, only7% of these trials had a low risk of bias, and most were conducted in the acute phase, limiting the strength of clinical recommendations
Mehrabi S , Harnett A , Saikaley M , Fleet J L , Eng J J , Bayley M , Teasell R Female enrollment in rehabilitation trials: A systematic review of reporting sex and female participation in randomized controlled trials of poststroke upper extremity rehabilitation over 50 years Archives of Physical Medicine and Rehabilitation
This systematic review found that women comprised only38 8% of participants in randomized controlled trials of post-stroke upperextremityrehabilitation overthe past 50 years. Female enrollment was higherin acute-phase studies but showed no significant improvement overtime, indicating persistent underrepresentation.
Park S., Tang A., Barclay R., ... Teasell R., ..., Sakakibara B. Investigating the Telerehabilitation With Aims to Improve Lower Extremity Recovery Poststroke Program: A Feasibility Study. Physical Therapy
This studyfound that delivering avirtual lowerextremityrehabilitation program (TRAIL) to people recovering from stroke is feasible andwell-received Participants showed improvements in mobility, leg strength, and personal goal achievement, suggesting thatvirtual rehab maybe avaluable option during recoveryat home
Safaei-Qomi M R , Mehrabi S , Fleet J L , Peters S , Viana R , Payne M W , Tang A , Teasell R Systematic review of worldwide female enrollment in randomized controlled trials of poststroke lower extremity rehabilitation American Journal of Physical Medicine and Rehabilitation
This review showed that female participation in poststroke lowerextremityrehabilitation trials remains low, averaging 39 5%,with no significant improvement overthe past two decades Participationwas higherin acute-phase trials and in European studies compared to those inAsia and Oceania The findings highlight the need to address sex reporting and underrepresentation ofwomen in stroke rehabilitation research
Simpson L.A., Barclay R., Bayley M.T., Brasher P.M.A., Dukelow S.P., MacIntosh B.J., ..., Teasell R., ..., Eng J.J. A randomized control trial of a virtually delivered program for increasing upper limb activity after stroke. Neurorehabilitation and Neural Repair
This randomized controlled trial found that a 3-weekvirtual upperlimb rehabilitation program including home exercises,wearable reach-to-grasp feedback, and therapist support significantlyincreased dailyarm use in stroke survivors The results support the effectiveness of telerehabilitation in enhancing real-world upperlimb activitypoststroke
Swartz R H , Longman R S , Lindsay M P, Lund R , Ganesh A , Eskes G A , , Bhangu J , , Smith E E Canadian stroke best practice recommendations: vascular cognitive impairment, 7th edition practice guidelines update, 2024 Alzheimer's and Dementia
This updated guideline introduces the first dedicated Canadian recommendations forrecognizing and managingvascularcognitive impairment afterstroke. It promotes early diagnosis and coordinated care to improve outcomes forstroke survivors
Teasell R., Fleet J.L., Harnett A. Post stroke exercise training: intensity, dosage, and timing of therapy. Physical Medicine and Rehabilitation Clinics of North America
This review highlights that initiating rehabilitation earlyafterstroke leads to bettermotorrecovery,whereas delays require highertherapydoses forsimilaroutcomes It emphasizes the importance of timely, intensive interventions to maximize functional gains
Teasell R., Mehrabi S., Saikaley M., George C., Dukelow S.P., Harnett A., Fleet J.L. A systematic review of upper extremity outcome measures assessed in randomized controlled trials of post stroke upper extremity rehabilitation over time. Topics in Stroke Rehabilitation
This systematic review of 1,276 randomized controlled trials identified 112 different outcome measures used in post-stroke upperextremityrehabilitation,with the FuglMeyerAssessment being the most common The findings highlight a need forstandardization to improve consistencyand comparabilityin stroke rehabilitation research
Teasell R., Safaei-Qomi M.R., Fleet J.L., Dukelow S.P., Murie-Fernandez M., Harnett A., Mehrabi S. Comparing the characteristics of randomized controlled trials of post-stroke upper extremity rehabilitation in low-middle-income and high-income countries
American Journal of Physical Medicine and Rehabilitation
Randomized trials in low- and middle-income countries focus more on subacute stroke recovery,while high-income countries target chronic phases. Studies from low- and middle-income countries are published in lower-impact journals despite similarquality
Wiley E , Sakakibara B , Park S , , Teasell R , Yao J , Tang A Exploring the experiences of an exercise-based telerehabilitation program among Canadian community-dwelling adults with stroke Disability and Rehabilitation
This studyshowed that theTRAILtelerehabilitation program iswell-received and effective forpost-stroke lowerlimb recovery, helping improve mobilityand strengthwith propersupport and guidance
Allison D J , Ebrahimzadeh S , Muise S , Joseph S , Roa Agudelo A , Lawson A , Billias N , Tran J , Smith A , Loh E Intra-articular corticosteroid injections versus platelet-rich plasma as a treatment for cervical facetogenic pain: A randomized clinical trial Regional Anesthesia and Pain Medicine
This studyshowed that platelet-rich plasma and corticosteroid injections provided similarpain and disabilityrelief forcervical facetogenic pain However, platelet-rich plasma led to greatershort-term improvements in pain self-efficacyand caused less procedural pain
Allison D.J., Loh E., Burnham R., Burnham T., Smith A. Leukocyte poor platelet rich plasma vs leukocyte rich platelet rich plasma as a treatment for cervical facetogenic pain: a pooled analysis Interventional Pain Medicine
This pooled analysis compared leukocyte-rich (LR-PRP) and leukocyte-poorplatelet-rich plasma (LP-PRP) injections fortreating cervical facet joint pain LR-PRPprovided greaterpain relief and functional improvement at 6 months,with feweradverse events, suggesting it maybe the more effective and saferoption
Alhassani G., Clothier P.J., Liston M.B., Schabrun S.M. Interhemispheric inhibition between primary motor cortices is not altered in individuals with chronic lateral epicondylalgia. Journal of Pain
This studyshowed that individualswith chronic lateral epicondylalgia did not exhibit altered interhemispheric inhibition orbilateral sensorimotordysfunction compared to healthycontrols These findings suggest that othermechanisms mayexplain the occasional bilateral symptoms seen in some cases of unilateral LE
Chang W J , Humburg P, Jenkins L C , Buscemi V , Gonalez-Alvarez M E , McAuley J H , Liston M B , Schabrun S M Can assessment of human assumed central sensitisation improve the predictive accuracy of the STarT Back screening tool in acute low back pain? Musculoskeletal Science and Practice
This studyshowed that the STarTBackTool has limited abilityto predict recoveryfrom acute low back pain at six months, and adding measures of central sensitisation does not improve its accuracy These findings suggest a need forbetterpredictive tools in earlyLBPmanagement
Chang W.J., Jenkins L.C., Humburg P., Schabrun S.M. Temporal changes in cortical sensory processing during the transition from acute to chronic low back pain Pain Reports
This studytracked brain activityin 120 individualswith acute low back pain oversix months.Thosewho developed chronic pain showed increasing sensorycortex responses overtime,while thosewho recovered did not These changes in brain processingwere not linked to pain sensitivity, suggesting distinct neural pathways in the transition to chronic pain
Chowdhury N.S., Bi C., Furman A.J., Chiang A.K.I., Skippen P., Si E., ..., Schabrun S.M., Seminowicz D.A. Predicting individual pain sensitivity using a novel cortical biomarker signature. JAMA Neurology
This studyidentified a brain-based biomarkercombining EEG andTMS measures that accuratelypredicts individual pain sensitivity The biomarkerdemonstrated high reliabilityand could help identifythose at risk of developing chronic pain
Chowdhury N S , Chang W J , Cavaleri R , Chiang A K I , Schabrun S M The reliability and validity of rapid transcranial magnetic stimulation mapping for muscles under active contraction BMC Neuroscience
This studyevaluated a rapid transcranial magnetic stimulation (TMS) mapping method forassessing the masseterand quadriceps muscles during active contraction.The rapid method produced similarresults to traditional mapping techniques, particularlyin measuring mapvolume, though reliabilityvaried across otherparameters Overall, rapidTMS mapping offers a fasteralternative forstudying muscle cortical representations
Chowdhury N.S., Millard S.K., De Martino E., Larsen D.B., Seminowicz D.A., Schabrun S.M., ..., Graven-Nielsen T. Posteriorsuperior insula repetitive transcranial magnetic stimulation reduces experimental tonic pain and pain-related cortical inhibition in humans. Pain
This studyshowed that high-frequencyrTMS to the posterior-superiorinsula reduced pain from capsaicin in healthyadults The pain reliefwas linked to changes in brain activity, specificallya reduction in the N45TMS-evoked potential These results support both the effectiveness of PSI-rTMS and the N45 signal as a markerof pain and pain relief
Chowdhury N.S., Taseen K.J., Chiang A.K.I., Chang W.J., Millard S.K., Seminowicz D.A., Schabrun S.M. A 5-day course of repetitive transcranial magnetic stimulation before pain onset ameliorates future pain and increases sensorimotor peak alpha frequency. Pain
This studydemonstrated that five consecutive days of high-frequencyrTMS applied to the primarymotorcortex before inducing prolonged jaw pain significantlyreduced future pain intensity Participantswho received active rTMS reported less pain during activities like chewing andyawning, alongwith an increase in sensorimotorpeak alpha frequency a brain activitymarkerassociatedwith pain modulation
Jenkins L.C., Chang W.J., Humburg P., ..., Schabrun S.M. Sex differences in the serum proteomic profile during acute low back Pain A preliminary study of the relationship to future low back pain. Journal of Pain
This studyshowed that males and femaleswith acute low back pain have distinct serum protein profiles linked to immune and inflammatoryprocesses These differences mayinfluencewhethersymptoms persist at three months, highlighting the potential forsex-specific biological pathways in the transition to chronic pain
Jobin K., Campbell C., Schabrun S.M., Schneider K.J., Smith A., Debert C.T. The safety and feasibility of transcranial direct current stimulation combined with conservative treatment for patients with cervicogenic headaches: A double-blinded randomized control study protocol Contemporary Clinical Trials Communications
This studywill test whethercombining tDCS with conservative treatment is a safe and feasible approach formanaging cervicogenic headaches.The resultswill guide future large-scale clinical trials
Jobin K , Smith A , Campbell C , Schabrun S M , Galarneau J M , Schneider K J , Debert CT The safety and feasibility of transcranial direct current stimulation and exercise therapy for the treatment of cervicogenic headaches: A randomized pilot trial Headache
This pilot trial confirmed that combining transcranial direct current stimulation (tDCS)with exercise therapyis a safe and feasible approach fortreating cervicogenic headaches Participants receiving active tDCS reported greaterreductions in headache and neck pain compared to the sham group
Jones-Whitehead C , Tran J , Wilson TD , Loh E Evaluation of a novel nerve ablation technique to relieve lower back pain: A cadaveric feasibility pilot study Pain Medicine
This cadaveric pilot studydemonstrated that a novel parasagittal technique forlumbarmedial branch radiofrequencyablation is anatomicallyfeasible The approach achieved precise needle placement neartarget nerves, suggesting potential forimproved outcomes in treating facet-related low back pain
O’Hagan E.T., Traeger A.C., Schabrun S.M., ..., McAuley J.H. It's OK to move! Effect of a brief video on community confidence in activity despite back pain: A randomized trial. Journal of Orthopaedic and Sports Physical Therapy
This studyshowed thatviewing brief social mediavideos about low back pain slightlyincreased participants’ confidence to stayactive despite pain compared to no intervention However, the small improvement is likelynot clinicallymeaningful
Tran J., Alboog A., Barua U., Billias N., Loh E. Optimal caudal needle angulation for lumbar medial branch denervation: A 3D cadaveric and clinical imaging comparison study. Interventional Pain Medicine
This studyfound that optimal needle placement forlumbarmedial branch denervation requires greatercaudal angulation than typicallyused in clinical practice Using 3D cadaveric models, researchers determined that achieving parallel alignment with the nerve necessitates steeperangles, suggesting current techniques maybenefit from adjustment to enhance procedural effectiveness
Tran J., Lawson A., Billias N., Loh E. 3D nerve proximity mapping of the medial branch of lumbar dorsal ramus: An anatomical study. Interventional Pain Medicine
This anatomical studyemployed 3D modeling to map the medial branch of the lumbardorsal ramus, identifying consistent contact along the posteriorlateral neck of the superiorarticularprocess It also introduced a novel sub-mammillarytarget that mayenhance the effectiveness of medial branch denervation
Tran J., Billias N., Burnham T., Burnham R., Loh E. Targeting the lateral neck of superior articular process and sub-mammillary fossa for lumbar medial branch radiofrequency ablation: A case series. Interventional Pain Medicine
This case series introduces a novel two-target approach forlumbarmedial branch radiofrequencyablation, focusing on the posteriorlateral neck of the superiorarticularp rocess and the sub-mammillaryfossa All fourpatients reported at least 80% pain relief lasting over12 months, indicating promising outcomes forthis technique
Tran J., Campisi E.S., Agur A.M.R., Loh E. Quantification of needle angles for lumbar medial branch denervation targeting the posterior half of the superior articular process: An osteological study Pain Medicine
This studyshowed that targeting the posteriorhalf of the lateral neck of the superiorarticularprocess forlumbarRFAtypicallyrequires less than 10° of lateral angulation, but cranial-to-caudal anglesvarybylevel The findings highlight that individualized needle angles maybe more effective than a uniform approach
Tran J , Campisi E S, Roa Agudelo A , Agur A M , Loh E High-fidelity 3D modelling of the lumbar dorsal rami Interventional Pain Medicine
High-fidelity3D modeling showed that targeting the anteriorquarterof the superiorarticularprocess risks lateral branch damage The studyrecommends aiming forthe midpoint to improve safetyduring lumbarmedial branch ablation
Tran J., Conger A., Lightfoot K., McCormick Z.L., Loh E. Lumbar facet joint denervation targeting the medial branch in the submammillary fossa: An anatomical optimization study. Interventional Pain Medicine
This anatomical studyevaluated needle placement forlumbarfacet joint denervation targeting the medial branch in the sub-mammillaryfossa Using cadaveric dissection a nd 3D modeling, researchers proposed refined fluoroscopic landmarks to enhance nerve capture and procedural accuracy
Tran J , Lawson A , Agur A , Loh E Parasagittal needle placement approach for lumbar medial branch denervation: a brief technical report Regional Anesthesia and Pain Medicine
This technical report describes a parasagittal needle placement technique forlumbarmedial branch radiofrequencydenervation, targeting the posteriorhalf of the lateral neck of the superiorarticularprocess. In fourpatients treatedwith this approach, pain relief outcomes suggest the technique maybe aviable alternative, though clinical data remains limited
Xiong H.Y., Hendrix J., Schabrun S., Wyns A., Campenhout J.V., Nijs J., Polli A. The role of the brain-derived neurotrophic factor in chronic pain: Links to central sensitization and neuroinflammation. Biomolecules
This studyshowed that brain-derived neurotrophic factor(BDNF) plays a crucial role in chronic pain bydriving central sensitization and neuroinflammation through its effects on synaptic plasticityand neuronal excitability Understanding BDNF’s molecularmechanisms highlights its potential as both a biomarkerand therapeutic target formanaging chronic pain
Xiong H Y , Wyns A , Campenhout JV, Schabrun S , Nijs J , Polli A Epigenetic landscapes of pain: DNA methylation dynamics in chronic pain International Journal of Molecular Sciences
This studyshowed that DNAmethylation regulates genes linked to pain and plays a keyrole in chronic pain development.Targeting these epigenetic changes mayoffer new biomarkers and therapies forbetterpain management
Yu P.J., Loh E., Agur A.M.R., Tran J. Advanced three-dimensional anatomical mapping of saphenous and inferior medial genicular nerve branching: enhancing precision in knee joint denervation. Pain Medicine
3D mapping showed that targeting the infrapatellarbranch of the saphenous nerve reliablycaptures the inferiormedial genicularnerve This can improve accuracyin knee joint denervation procedures
Barua U , Ahrens J , Shao R , MacKenzie H , Wolfe D , Sequeira K , Teasell R , Loh E., Mehta S Cognitive behavioral therapy for managing depressive and anxiety symptoms after brain injury: A meta-analysis Brain Injury
This meta-analysis found that cognitive behavioral therapy(CBT) effectivelyreduces depression and anxietysymptoms in adults recovering from brain injury.The benefits were sustained at a 3-month follow-up,with individualized CBTshowing slightlygreatereffects than group-based therapy
Flores-Sandoval C , MacKenzie H M , McIntyre A , Sait M , Teasell R , Bateman E A Mortality and discharge disposition among older adults with moderate to severe traumatic brain injury Archives of Gerontology and Geriatrics
This studyshowed that olderadultswith moderate to severe traumatic brain injuryhave high mortalityrates especiallythose over80 and are less likelyto be discharged home compared toyoungerpatients Manyare instead discharged to long-term care, rehabilitation, orhospice, underscoring the need fortargeted care strategies
Flores-Sandoval C , Bateman E.A , MacKenzie H M , Sequeira K , Janzen S , Teasell R An overview of medical, surgical, and rehabilitation outcome measures used in randomized controlled trials of moderate to severe traumatic brain injury American Journal of Physical Medicine and Rehabilitation
This review analyzed 662 randomized controlled trials on moderate to severe traumatic brain injuryand found 839 unique outcome measures,with only23% used in multiple studies Thewidevariation in measures limits the abilityto compare results across trials and highlights the need forstandardization
Flores-Sandoval C , MacKenzie H M , Bateman E A , Sequeira K , Bayley M , Teasell R Sex differences in moderate-to-severe traumatic brain injury randomized controlled trials Canadian Journal of Neurological Sciences
This review found that women made up just 23% of participants in randomized trials formoderate-to-severe traumatic brain injury Female representationwas especiallyl ow in studies startedwithin the first month afterinjury The findings highlight a need formore inclusive research to ensure treatmentswork foreveryone
Flores-Sandoval C., Teasell R., MacKenzie H.M., McIntyre A., Barua U., Mehta S., ..., Bateman E.A. Evidence-based review of randomized controlled trials of interventions for mental health management post-moderate to severe traumatic brain injury. Journal of Head Trauma Rehabilitation
This review analyzed 87 randomized trials on mental health treatments aftermoderate to severe traumatic brain injury Cognitive behavioral therapy, acceptance and commitment therapy, and activities likeTai Chi showed benefits fordepression, anxiety, and stress Some medicationswere helpful, but resultsvaried
Hunt C., Mackenzie H., Dosaj A., Zych J., Tartaglia C., Bayley M., ..., Baker A. Connecting concussion care with research across Ontario. Canadian Journal of Neurological Sciences
The CONNECTinitiative in Ontario established a province-wide network to standardize concussion care byimplementing common data elements (CDEs) across clinics This harmonized approach enhances patient care, reduceswait times, and facilitates large-scale research collaborations, positioning Ontario as a leaderin evidence-based concussion management
MacKenzie H.M., Flores-Sandoval C., Bateman E.A., McIntyre A., Barua U., Mehta S., ..., Teasell R. Evidence-based review of randomized controlled trials of interventions for the management of behavioral issues in individuals with moderate to severe traumatic brain injury. Journal of Head Trauma Rehabilitation
This studyreviewed 46 trials and found that both medications (e g , amantadine) and non-drug therapies (e g , angermanagement, peermentoring) can effectivelyaddress behavioral issues in moderate to severe traumatic brain injury
MacKenzie H.M., Velikonja D., Devito J., Devito L., Patsakos E.M., Bayley M., Teasell R., Mehta S. Updated Canadian clinical practice guideline for the rehabilitation of adults with moderate to severe traumatic brain injury: Behavioral recommendations.
Journal of Head Trauma Rehabilitation
This guideline provides 21 updated recommendations to help clinicians manage behavioral issues like agitation and apathyin adultswith moderate to severe brain injury It offers a practical algorithm to support individualized care
Mehta S., Devito L., Patsakos E.M., Devito J., Velikonja D., Bayley M., Teasell R., MacKenzie H.M. Updated Canadian Clinical Practice Guideline for the Rehabilitation of Adults with Moderate to Severe Traumatic Brain Injury: Mental Health Recommendations. Journal of Head Trauma Rehabilitation
This initiative updated the Canadian guidelines formanaging mental health conditions aftermoderate to severe traumatic brain injury The CAN-TBI 2023 guideline includes 20 recommendations, emphasizing routine screening and multimodal treatment approaches Most recommendations are based on lower-level evidence, highlighting the need forfurtherresearch
Mehrabi S., Flores-Sandoval C., Bateman E.A., MacKenzie H.M., Billias N., Teasell R. Non-Pharmacological Complementary and Alternative Medicine Therapies in Randomized Controlled Trials of Moderate to Severe Traumatic Brain Injury. Current Physical Medicine and Rehabilitation Reports
This review found that most randomized trials on non-pharmacological CAM therapies formoderate to severe traumatic brain injuryare low qualityand highlyvaried While some interventions like music therapyand acupuncture are more commonlystudied, the evidence remains too limited to support clearclinical recommendations
Patsakos E.M., Kua A., Gargaro J., Yaroslavtseva O., Teasell R., Janzen S., Harnett A. Bennett P., Bayley M. Lessons Learned from moving to living guidelines - The Canadian clinical practice guideline for the rehabilitation of adults with moderate-to-severe TBI. Journal of Head Trauma Rehabilitation
This initiative showed that transforming the CanadianTraumatic Brain Injuryrehabilitation guideline into a living guideline enables continuous, real-time updates as new evidence emerges This approach ensures practitioners have access to the most current and relevant recommendations amid rapidlygrowing research
Teasell R., Flores-Sandoval C., Bateman E.A., MacKenzie H.M., Sequeira K., Bayley M., Janzen S. Overview of randomized controlled trials of moderate to severe traumatic brain injury: A systematic review. NeuroRehabilitation
This studyshowed that most randomized trials formoderate to severeTBI focus on medical orsurgical interventions,with feweraddressing rehabilitation Rehabilitation RCTswere smallerand largelyconducted in the chronic phase, highlighting the need formore research across all phases of care to improve long-term outcomes
Teasell R., MacKenzie H.M., Flores-Sandoval C., McIntyre A., Barua U., Mehta S., ..., Bateman E.A. Experiences and challenges updating a living evidence-based review of randomized controlled trials on mental health and behavioral disorders in individuals with moderate to severe traumatic brain injury. Journal of Head Trauma Rehabilitation
This review highlights significant challenges in updating a living evidence-based database of RCTs on mental health and behavioral disorders in moderate to severeTBI, including inconsistent reporting of injurydetails andvaried outcome measures These issues hinderdata comparison and the development of robust clinical guidelines
Teasell R., Flores-Sandoval C., Janzen S., MacKenzie H.M., Mehrabi S., Sequeira K., ..., Bateman E.A. Comparing randomized controlled trials of moderate to severe traumatic brain injury in lower to middle income countries versus high income countries
Journal of Neurotrauma
Lower- and middle-income countries now publish moreTBI trials than high-income countries, focusing mainlyon acute care. In contrast, high-income countries prioritize rehabilitation research
Tsow R , Pollock C , Mehta S , Turcott A , Kang R , Schmidt J A look at traumatic brain injury community programs in British Columbia: barriers and facilitators of implementation Brain Injury
This studyexamined community-based programs in British Columbia that support acceptance and resiliencyforindividualswith traumatic brain injury. Keyfacilitators included stable leadership and shared lived experiences,while majorbarrierswere inconsistent funding and limited institutional support
Ahrens J., Upper R., Loh E., Wolfe D., Giurleo C., Courten E., Janzen S., Seliman M., Mehta S. Internet-based sexual health resources for those living with spinal cord injury: A content analysis. Journal of Spinal Cord Medicine
This review showed that most online sexual health resources forpeoplewith spinal cord injuryfocus on male sexual function and reproduction,with little content forwomen orLGBTQ+ individuals The findings highlight a need formore inclusive, diverse resources
Allison D J , Ahrens J , Mirkowski M , Mehta S , Loh E The effect of neuropathic pain treatments on pain interference following spinal cord injury: A systematic review Journal of Spinal Cord Medicine
This review showed that treatments like pregabalin, gabapentin, and electrical stimulation therapies can reduce how much neuropathic pain interfereswith dailylife for peoplewith spinal cord injury These approaches offervaluable options forimproving comfort and function
Craven B.C., Souza W.H., ..., Wolfe D., ..., Gagnon D. Reducing endocrine metabolic disease risk in adults with chronic spinal cord injury: strategic activities conducted by the Ontario-Quebec RIISC team. Disability and Rehabilitation
This studyshowed that adultswith chronic spinal cord injuryface high risks of endocrine metabolic disease (EMD),yet few rehab interventions address it The RIISC team proposed a new model that shifts awayfrom single-disease approaches and promotes real-world research in outpatient settings to betterprevent EMD and reduce related health impacts
Cano-Herrera C L , Manhas G , Querée M , Hoogenes B , Bateman E A , Loh E , , Eng J J Treatments of fatigue after spinal cord injury: a systematic review and meta-analysis Spinal Cord
This systematic review and meta-analysis evaluated interventions forfatigue in individualswith spinal cord injury The findings suggest that exercise and behavioral interventions promoting an active lifestyle mayeffectivelyreduce fatigue, though more research is needed to establish standardized treatment protocols
Craven B.C., Bateman E.A., Flett H., Farahani F., Wolfe D.L., Askari S., ..., Alavinia M. The changing prevalence of pressure injury among ontarians with sci/d at rehabilitation admission: Opportunities for improvement. Healthcare
This studyfound that pressure injuries (PIs) present at rehabilitation admission among Ontarianswith spinal cord injury/disease have increased, especiallysevere sacral wounds However, new PIs acquired during rehab have declined since 2021, likelydue to dailyskin checks These findings highlight the need forearlierprevention efforts before rehab begins
Jervis-Rademeyer H , Gautam S , Cornell S , Khan J , Wilanowski D , Musselman K E , Wolfe D L , , Ho C Development of a functional electrical stimulation cycling toolkit for spinal cord injury rehabilitation in acute care hospitals: a participatory action approach PLoS ONE
This studydeveloped a practical toolkit to help hospitals integrate functional electrical stimulation (FES) cycling into earlyspinal cord injuryrehab Co-designedwith clinicians and patients, the toolkit supports faster, more consistent adoption of FES in acute care settings
Mistry J., White L., Baraks K., ..., Schabrun S., ... Rushton A. Patient lived experiences of functioning and disability following lumbar discectomy: A secondary analysis of qualitative data. BMC Musculoskeletal Disorders
This studyexplored patient experiences afterlumbardiscectomyand found shared short-term impacts butvaried long-term recoverypaths shaped bypersonal coping styles Most experiences alignedwith the ICFframework, though some aspects, like personal control,were not fullycaptured
Nageswaran L., Wolfe D.L., Graham L.J., Bateman E.A. Taking risk to heart: An evaluation of cardiometabolic risk and screening guideline adherence in outpatients with spinal cord injury. Journal of Spinal Cord Medicine
This studyfound that 94 5% of outpatientswith spinal cord injuryhad at least one cardiometabolic risk factor,yet screening adherencewas poor,with hypertension and obesityassessments completed at only14 3% and 10 4% ofvisits, respectively Eighteen barriers to effective screening and treatment were identified, underscoring the need forimproved preventive care strategies in this population
Phelps N., Marrocco S., Cornell S., Wolfe D.L., Lizotte D.J. Reinforcement learning in large, structured action spaces: a simulation study of decision support for spinal cord injury rehabilitation. Intelligence-Based Medicine
This studydeveloped a simulatorto model spinal cord injuryrehabilitation and proposed two methods forgrouping treatments to facilitate effective reinforcement learning The approach based on domain knowledge outperformed the embedding technique, demonstrating the potential of reinforcement learning to enhance clinical decisionmaking in rehabilitation
Playfair M , McClure J A , Le B , Cassidy C , Wang P, Welk B , Dave S The impact of transition of spina bifida care: a retrospective population-based cohort study comparing outcomes and health care costs longitudinally from adolescence into adulthood Pediatrics and Child Health
This studyfound that aftertransitioning to adult care, individualswith spina bifida experienced increased unplanned emergencyvisits and surgeries,yet overall healthcare costs decreased. Rural residence and priorurologic surgerywere linked to higheracute care needs, indicating areas fortargeted intervention.
Ali P., Dinomais M., Labriffe M., Pieruccini-Faria F., Montero-Odasso M., Bartha R., Annweiler C. Mapping the neural substrate of high dual-task gait cost in older adults across the cognitive spectrum. Brain Structure and Function
This studyshowed that olderadultswho slow down morewhilewalking and doing a mental task have smallerbrainvolumes in keyareas These brain changes mayhelp identifyearlysigns of cognitive decline
Ali P, Pieruccini-Faria F , Annweiler C , Dinomais M , Son S , Wilson S K , , Montero-Odasso M Smaller cingulate grey matter mediates the association between dual-task gait and incident dementia Brain
This studyfound that olderadultswith mild cognitive impairment whowalked slowerwhile multitaskingwere more likelyto develop dementia.The linkwas partlyexplained bysmallergreymattervolume in the right cingulate cortex, suggesting this brain region plays a role in the progression to dementia
Faerman M.V., Cole C., Van Ooteghem K., Cornish B.F., Howe E.E., Siu V., Montero-Odasso M ..., Martens K.A.E. Motor, affective, cognitive, and perceptual symptom changes over time in individuals with Parkinson’s disease who develop freezing of gait. Journal of Neurology
This studyfollowed peoplewith Parkinson’s overtwoyears to identifywho developed freezing of gait Worsening motorsymptoms and longerdisease duration predicted freezing earlieron,while mood and memorychanges became strongerpredictors closerto onset The results help explainwhypast studies have found inconsistent predictors.
Fitzgibbon-Collins L.K., Borrie M., Peters S., Shoemaker J.K., Bhangu J. Dynamic cerebral autoregulation in people with mild cognitive impairment. Journal of Cerebral Blood Flow and Metabolism
This studyshowed that peoplewith mild cognitive impairment and highercerebral blood flow had poorerautoregulation but bettercognitive scores The results suggest possible compensatoryblood flow changes in earlyneurodegeneration
Fitzgibbon-Collins L K , Coombs G B , Noguchi M , Parihar S , Hughson R L , Borrie M , , Bhangu J Standing middle cerebral artery velocity predicts cognitive function and gait speed in older adults with cognitive impairment, and is impacted by sex differences Cerebral Circulation - Cognition and Behavior
This studyfound that lowermiddle cerebral arteryblood flowwhile standing is linked to poorercognition and slowergait in olderadultswith cognitive impairment These associationswere strongerin men andwere not observedwhen participantswere lying down
Heckman G.A., Bhangu J., Graham M.M., Keen S., O'Neill D.E. Geriatric cardiology: Moving beyond learning by osmosis. Canadian Journal of Cardiology
This editorial emphasizes the need forstructured training in geriatric cardiology, moving beyond informal learning methods It advocates fornational initiatives to equip clinicianswith the skills necessaryto manage the complex needs of olderadultswith cardiovascularconditions
Lin WZ , Yu D , Xiong LY, Zebarth J , Wang R , Fischer C E , , Montero-Odasso M , , McLaughlin P Homocysteine, neurodegenerative biomarkers, and APOE ε4 in neurodegenerative diseases Alzheimer's and Dementia
This studyfound that elevated homocysteine levels are linked to neurodegeneration markers and cognitive decline inAPOE ε4 non-carriers, suggesting that genetic background influences homocysteine's impact on brain health
Montero-Odasso M., Pieruccini-Faria F., Son S., Carvalho De Abreu D.C., Hunter S., Liu J.Q., ..., Speechley M. Fall risk stratification in older adults: Low and not-at-risk status still associated with falls and injuries. Age and Ageing
This studyfound that 41% of olderadults classified as not-at-risk experienced falls,with 63% of these resulting in injuries Slow gait speed (<1 m/s) doubled the risk of injurious falls, suggesting that routine gait speed assessment could improve fall risk detection
Montero-Odasso M , Van Der Velde N , Ryg J , Masud T Falls risk stratification one size doesn't fit all Age and Ageing
This editorial argues that standard fall risk tools mayoverlook manyolderadultswho still experience falls, emphasizing that a uniform approach is insufficient. It advocates formore individualized assessments that considerfactors like gait speed and functional mobilityto betteridentifythose at risk
Pieruccini-Faria F., Hachinski V., Son S., Montero-Odasso M. Apathy, gait slowness, and executive dysfunction (aged) triad: opportunities to predict and delay dementia onset. GeroScience
This studyfound that olderadults exhibiting theAGED triad apathy, slow gait, and executive dysfunction had a fivefold increased risk of developing dementia The triad s erves as a simple clinical markerforearlyidentification and intervention
Shoemaker L.N., ..., Fitzgibbon-Collins L., ..., Bhangu J., Shoemaker J.K., Lawrence K.S. Two paths to one destination: altered lowfrequency oscillations of cerebral perfusion and oxygenation but not oxygen metabolism in mild cognitive impairment. Journal of Applied Physiology
This studyused optical monitoring to detect altered blood flow and oxygenation patterns in peoplewith mild cognitive impairment The findings suggest early cerebrovasculardysfunction despite preserved brain metabolism
Smith E E , Phillips N A , Feldman H H , Borrie M , Ganesh A , Henri-Bhargava A , , Montero-Odasso M , , Chertkow H Use of lecanemab and donanemab in the Canadian healthcare system: Evidence, challenges, and areas for future research The Journal of Prevention of Alzheimer's Disease
This studyfound that lecanemab and donanemab, monoclonal antibodies targeting amyloid-beta, show modest cognitive benefits in earlyAlzheimer's disease However, implementing these therapies in Canada poses challenges due to diagnostic and monitoring requirements that could strain healthcare resources
Stephen A., Connelly D., Hung L., Unger J. Staff-family communication methods in long-term care homes: an integrative review. Journal of Long-Term Care
This integrative review identified structured education, meetings, and takeawayresources as keymethods to enhance staff-familycommunication in long-term care homes It emphasizes that staff training, technologysupport, and accessible information are essential forfostering person-centred care and improving resident outcomes
Trafford D., Liu Y., Papaioannou A., Ioannidis G., Thain J. Canadian inpatient orthogeriatric models of care: a mixed methods survey of facilitators and barriers. Canadian Geriatrics Journal
This national surveyfound that most Canadian hospitalswith orthogeriatric programs credit clinical leadership as the keyfacilitator,while lack of hospital prioritization and funding are the main barriers to implementation The findings underscore the need forinstitutional support to expand geriatric-orthopedic care models
Yogaparan T, Burrell A , Talbot-Hamon C , Sadowski C A , Grief C , MacDonald E , , Thain J , , Bach TV The aging care 5ms competencies: a modified delphi study to revise medical student competencies for the care of older adults Academic Medicine
This studyupdated Canadian medical student competencies in geriatric care using the Geriatric 5Ms framework Mind, Mobility, Medications, Multi-complexity, and Matters Most resulting in 33 consensus-based competencies.The revised competencies aim to betterprepare future physicians to meet the complex needs of an aging population
Bateman E A , Viana R , Sales D , Payne M W Pregnancy after amputation: A national survey of prosthetic and mobility outcomes in women with lived experience Prosthetics and Orthotics International
This studyfound that womenwith lowerextremityamputations (LEAs) face unique mobilitychallenges during pregnancy, including reduced prosthesis use, increased need forgait aids, and a high rate of complications like back pain and balance issues These findings underscore the need forbetterclinical guidance and support forthis population during pregnancy.
Frengopoulos C., Neferu R., Pasquali M., Viana R., Miller T., Payne M.W. Botulinum toxin therapy for management of phantom and residual limb pain following amputation: A systematic review. Prosthetics and Orthotics International
This systematic review examined the use of botulinum toxin injections forphantom and residual limb pain afteramputation Among 89 patients across 11 studies, overhalf experienced pain relief However, due to small sample sizes andvaried methods, more research is needed to confirm its effectiveness
Guilcher S JT, Mayo A L , Swayze S , Mestral C D , Viana R , Payne M W , , Hitzig S L Patterns of inpatient acute care and emergency department utilization within one year post-initial amputation among individuals with dysvascular major lower extremity amputation in Ontario, Canada: A population-based retrospective cohort study PLoS ONE
This studyfound that individuals in Ontariowho underwent majorlowerlimb amputation due tovasculardisease experienced high rates of hospital readmissions and emergencyvisitswithin ayear. Olderage, multiple health conditions, and less consistent follow-up care increased these risks.
Hitzig S L , Zidarov D , Mackay C , Dilkas S , Alshehri F, Russell R , , Viana R, Payne M W , , Mayo A L An environmental scan of limb loss rehabilitation centers across Canada Prosthetics and Orthotics International
This studysurveyed 31 Canadian limb loss rehabilitation centers and found significantvariabilityin services, staffing, and access to mental health and peersupport.The findings highlight the need fornational guidelines and a shared clinical database to standardize care
Madou E., Sureshkumar A., Payne M.W., Viana R., Hunter S.W. The effect of exercise interventions on gait outcomes in subacute and chronic rehabilitation from lower-limb amputation: A systematic review and meta-analysis. Prosthetics and Orthotics International
This systematic review and meta-analysis found that exercise programs combining gait, balance, and strength training improvewalking outcomes in peoplewith lower-limb amputation during both subacute and chronic rehabilitation The benefitswere more pronounced in the chronic phase, though optimal program duration and frequency remain unclear
Nugent K., Joshi A., Viana R., Payne M.W., Unger J., Hunter S.W. How has body image been evaluated among people with lower limb loss? a scoping review. Disability and Rehabilitation
This scoping review found that individualswith lowerlimb loss often experience negative bodyimage,yet most studies lacked a cleardefinition of the concept The authors propose a lowerlimb loss-specific definition to guide future research and clinical assessment
Rash I , Miller WC , Tao G , Payne M W What are relevant predictors of physical activity in older adults with lower limb loss (lll)? results of a retrospective analysis Prosthetics and Orthotics International
This studyfound that communitymobilityand physical performance are significant predictors of physical activityin olderadultswith lowerlimb loss Specifically, the Life SpaceAssessment and Short Physical Performance Batteryaccounted for25% of thevariance in activitylevels
Sureshkumar A., Payne M.W., Viana R., Hunter S.W. An eight-year analysis of participant characteristics at admission to inpatient prosthetic rehabilitation following a lower limb amputation: A Canadian perspective Disability and Rehabilitation
This eight-yearCanadian studyfound that individuals admitted forinpatient prosthetic rehabilitation afterlowerlimb amputation are presentingwith more comorbidities overtime but are being admitted sooneraftersurgery These trends highlight the need forrehabilitation programs to adapt to a more medicallycomplex population entering care at earlierstages of recovery
Nugent K , Viana R , Payne M W , Unger J , Hunter SW Understanding the multidimensionality of a concern for falling in people with unilateral transtibial amputation: A cross-sectional study. International Journal of Rehabilitation Research
This studyshowed that psychological concerns about falling in peoplewith lowerlimb loss are moderatelyinterrelated but not linked to priorfalls Instead, qualityof lifewas more stronglyassociatedwith fearof falling, confidence, and perceived abilityto manage falls, suggesting that concern forfalling should be assessed separatelyfrom falls history
Bateman E.A., Cassidy C., Reardon R., Fleet J.L. Are women physicians underrecognized for national awards in neuromuscular and electrodiagnostic medicine? An observational study. Muscle and Nerve
This studyanalyzed award data from theAmericanAssociation of Neuromuscularand Electrodiagnostic Medicine between 1957 and 2023 It found that only15 6% of physician awardswere given towomen,with significant disparities in prestigious categories like LifetimeAchievement While representation has improved overtime, a gendergap in recognition persists
Bateman E.A., Fortin C.D., Ghuman A., Neferu R., Guo M. Planetary Health in Rehabilitation: A Call to Arms. and Legs, Gait Aids, and Other Equipment. American Journal of Physical Medicine and Rehabilitation.
This position paperhighlights the need forenvironmental stewardship in rehabilitation medicine It recommends avoiding the disposal of reusable equipment to reduce waste and support planetaryhealth
Chala M.B., Elliott J., Baker G.R., Walton D.M., Steele M., Schabrun S. Integrated care for adults with chronic musculoskeletal disorders: A scoping review protocol. JBI Evidence Synthesis
This protocol outlines a scoping review aiming to explore how integrated care is defined, implemented, and assessed foradultswith chronic musculoskeletal disorders The reviewwill identifykeycomponents, outcomes, and barriers to inform future healthcare practices
Cimino S R , Crozier O , Lizotte D , Shabbir A , Stoikos J , Wolfe D L A co-design process to develop personalized mobility programming for individuals with mobility impairments Frontiers in Rehabilitation Sciences
This studydescribes a co-design approach involving individualswith mobilityimpairments, clinicians, and researchers to develop personalized mobilityprograms.The c ollaboration resulted in fourtailored programs: cognitive cardio, functional strength, mobilitycircuits, and open gym sessions This process ensures that mobilityi nterventions are relevant and responsive to the specific needs of participants
Clemens K.K., Son S., Zhu Y., Kanagalingam T., Thain J., D’Angelo S., Drosdowech D., Khan T. Prescribing outcomes following discharge from an osteoporosis specialist-led, post-fracture clinic: A prospective cohort study in Ontario, Canada Archives of Osteoporosis
This studyshowed that an osteoporosis specialist-led post-fracture clinic achieved high rates of medication initiation and persistence in real-world patientswith fragility fractures About 90% of patients filled theirprescribed treatment and remained persistent over6–9 months, suggesting this collaborative model could benefit otherfracture centers
Eggiman-Ketter J., Derrough B., Wolfe D.L., Unger J. Enablers and barriers to implementing an interdisciplinary experiential learning program for university students in a Canadian rehabilitation centre. Frontiers in Rehabilitation Sciences
This studyexploredwhat helps orhinders the rollout of an interdisciplinarystudent program in a rehab centre It found that staff motivation and clearroles supported success,while limited resourceswere a common challenge
Gueret J , Eng J J , Stelling S A , Pollock C L , Peters S Evaluating the educational experience of physiotherapy students using the fitness and mobility exercise (fame) programme to learn about neurological conditions: An exploratory study Physiotherapy Canada
This studyexplored physiotherapystudents' experiences using the FAME program during clinical placements Students reported that leading FAME sessions enhanced their understanding of neurological conditions and improved theirgroup management skills
Jeyakumaran T., Eggiman-Ketter J., Spadzinski A., Wolfe D.L. Identifying strategies and related principles supporting a co-design approach in an assistive device service delivery and research platform. Frontiers in Rehabilitation Sciences
This studyoutlines how the Possibilities Project Plus (PPPlus) used a co-design approach to improve access to assistive devices forpeoplewith disabilities Byintegrating inclusive governance, ongoing environmental scans, and Health EquityImpactAssessments, the project fostered meaningful stakeholderengagement and equitable outcomes in assistive technologyservice delivery
Kaur J., Im J., Buys Y., Trope G., Ngo G., Nichani P.A.H., Jin Y.P. Impact of eyewear insurance coverage on utilization of eyecare providers in Ontario, Canada. Canadian Journal of Ophthalmology
Ontarianswith eyewearinsurancewere significantlymore likelytovisit eye care providers than thosewithout coverage, even among age groups eligible forgovernmentfunded eye exams This highlights that the cost of prescription eyewear not just the exam remains a majorbarrierto accessingvision care
Naylor J.M., Gibson K., Mills K., Schabrun S.M., Livings R., Dennis S., Thom J. A snapshot of primary care physiotherapy management of knee osteoarthritis in an Australian setting: Does it align with evidence-based guidelines? Physiotherapy Theory and Practice
This studyfound that private physiotherapyforknee osteoarthritis inAustralia often falls short of guideline-based care, particularlyin education andweight management No clinics used outcome measures,yet most patients reported meaningful improvement and high satisfaction afterthree months
Neferu R , Fortin C , Guo M , Robinson L , Bateman E A Choosing wisely in physical medicine and rehabilitation developing Canadian recommendations for resource stewardship American Journal of Physical Medicine and Rehabilitation
This studyoutlines six updated recommendations aimed at reducing unnecessarytests and treatments in physical medicine and rehabilitation, such as avoiding imaging for low back painwithout red flags and limiting prolonged rest aftermild traumatic brain injury It also introduces implementation tools to help clinicians integrate these evidence-based practices into routine care
Nguyen J , Naylor J M , Dennis S , Livings R , Mills K , Schabrun S M , Thom J M Voices from the clinic: A qualitative analysis of physiotherapy strategies in musculoskeletal care for knee osteoarthritis patients BMC Musculoskeletal Disorders
This studyfound that physiotherapists in Sydneycommonlyprovided exercise and education forknee osteoarthritis but often deviated from guidelines byincorporating t reatments like hydrotherapyand manual therapy. Barriers such as limited consultation time, funding constraints, and lack of multidisciplinarysupport hindered full a dherence to evidence-based care
Unger J., Wolfe D.L., Bourke J., Middleton J. Editorial: Co-design of rehabilitation programming. Frontiers in Rehabilitation Sciences
This editorial emphasizes the importance of co-design in rehabilitation, highlighting its role in creating person-centered programs byinvolving individualswith lived experience It advocates forintentional, inclusive collaboration to move from co-design to co-production, enhancing the relevance and effectiveness of rehabilitation services.
Yaroslavtseva O., Gargaro J., Patsakos E.M., Nair A., Teasell R., Bayley M.T. From gaps to guidelines: A process for providing guidance to bridge evidence gaps. BioMedical Engineering Online
This paperoutlines a process to create clinical guidelineswhen evidence is limited, using expert input and lived experience to close critical care gaps
Anguelova G.V., VanderEnde J., van Houdt C.I.A., Saris C.G.J. Ulnar artery arteriovenous malformation with an intraneural ulnar nerve component; case report and literature review. Clinical Neurophysiology
This case report describes a rare instancewhere an abnormal connection between an arteryandvein (arteriovenous malformation) involved the ulnarnerve itself The authors emphasize the importance of consideringvascularanomalies in patientswith unexplained upperlimb neuropathies
Bateman E.A., Fortin C.D., Guo M. Musculoskeletal mimics of lumbosacral radiculopathy. Muscle and Nerve
This review outlines howvarious musculoskeletal conditions like hip osteoarthritis, myofascial pain, and plantarfasciitis can imitate the symptoms of lumbosacral radiculopathy It emphasizes the importance of thorough physical examinations to accuratelydistinguish these mimics from true nerve root issues
Knight S., Miller T.A., McIntyre A., Larocerie-Salgado J., Ross D.C. The hand diagram: A novel outcome measure following supercharged end-to-side anterior interosseous nerve to ulnar nerve transfer in severe compressive ulnar neuropathy. Journal of Hand Therapy
This studyintroduced the hand abduction diagram as a simple, quantitative tool to track recoveryof intrinsic hand function afterSETS nerve transfersurgery It offers clinicians a reproducible method to assess motorimprovement in patientswith severe ulnarneuropathy
Mehta S., Barua U., Nugent M., Hansen K., Sondhi L., Upper R., Wolfe, D.L., Loh, E., Sequeira, K., Teasell, R., Hadjistavropoulos H.D. Stakeholder perspectives on implementation of internet-delivered cognitive behaviour therapy in physical medicine rehabilitation setting using the consolidated framework for implementation research. Journal of Rehabilitation Medicine
This studyfound that stakeholdersviewed internet-delivered cognitive behaviourtherapy(ICBT) as beneficial and evidence-based forphysical rehabilitation settings However, challenges such as limited leadership engagement and resource constraints could hinderimplementation
Miller T A , Ross D C Sciatic and tibial neuropathies Handbook of Clinical Neurology
This chapterprovides a comprehensive review of sciatic and tibial nerve disorders, emphasizing the importance of detailed anatomical knowledge foraccurate diagnosis It also highlights advancements in surgical techniques, such as nerve transfers,which are enhancing outcomes in lowerlimb nerve reconstruction.
Mitchell E C , Mansouri M , Miller T , Ross D , Gillis J Early and late intrinsic hand muscle reinnervation after end-to-side ain to ulnar motor nerve transfer Hand
This studyfound that supercharged end-to-side anteriorinterosseous nerve (AIN) to ulnarmotornerve transferleads to reinnervation of intrinsic hand muscles,withvarying recoverypatterns between the first dorsal interosseous (FDI) and abductordigiti minimi (ADM) muscles The role of specific fasciculartargeting during the transferremains unclearandwarrants furtherinvestigation
Morales A., El Chamaa A., Mehta S., Rushton A., Battié M.C. Depression as a prognostic factor for lumbar spinal stenosis outcomes: A systematic review. European Spine Journal
This systematic review found that preoperative depression has a small to moderate prognosticvalue forpostoperative disabilityand symptom severityin lumbarspinal stenosis patients However, depression showed no significant prognosticvalue forpostoperativewalking capacity
Chang W.J., Chiang A., Chowdhury N., Adie S., Naylor J.M., Finn H., Rizzo R.R.N., Gorgon E., O'Hagan E., Schabrun S.M. Repetitive transcranial magnetic stimulation as an adjunct to quadriceps strengthening exercise in knee osteoarthritis: A pilot randomised controlled trial. BMJ Open
This studyshowed that combining rTMS with quadriceps strengthening forknee osteoarthritis is feasible, safe, andwell-tolerated Both groups improved in pain short-term, but onlythe active rTMS group showed functional gains post-intervention, supporting the need fora largertrial
Jobin K., Smith A., Campbell C., Schabrun S., Galarneau J.M., Schneider K.J. Debert C.T. The treatment of cervicogenic headache with transcranial direct current stimulation and exercise therapy: A randomized control trial evaluating functional outcomes. NeuroRehabilitation
This pilot studyshowed that combining active transcranial direct current stimulationwith exercise therapysignificantlyimproved deep cervical flexormotorcontrol in patientswith cervicogenic headache,with benefits lasting up to 12weeks These findings support the potential of tDCS to enhance functional outcomes in this population.
Krougly N., Tsikrikis K., MacRae F., Pouliopoulou D.V., Peters S. Linking brain activation to standing balance performance: A systematic review and meta analysis of functional near-infrared spectroscopy literature. Gait and Posture
This meta-analysis found that increased brain activityin the supplementarymotorarea and prefrontal cortex is moderatelycorrelatedwith standing balance performance
The findings support the use of fNIRS as a tool to assess neural control of balance in both clinical and research settings
Millard S.K., Speis D.B., Skippen P., ..., Schabrun S.M. Can non-invasive brain stimulation modulate peak alpha frequency in the human brain? A systematic review and meta-analysis. European Journal of Neuroscience
This review found that non-invasive brain stimulation, including tACS, tDCS, and rTMS, has limited and inconsistent effects on peak alpha frequency(PAF) in healthy adults While 10 Hz rTMS showed some potential fortransient PAFincreases, more targeted and higher-powered studies are needed to clarifywhethernoninvasive brain stimulation can reliablymodulate PAF
Nezon E., Patel T., Benson K., Chan K., Lee J.W., Inness E.L., ..., Wolfe D., Musselman K.E. Combining functional electrical stimulation with visual feedback balance training: A qualitative study of end-user perspectives on designing a clinically feasible intervention. BMJ Open
This studygathered feedback from patients, therapists, and administrators to design a balance training system combining FES withvisual feedback Users emphasized the need forawireless, modularsetup and bettertraining to support clinical use
Phylactou P , Pham T N M , Narskhani N , Diya N , Seminowicz D A , Schabrun S M Phosphene and motor transcranial magnetic stimulation thresholds are correlated: A meta-analytic investigation Progress in Neuro-Psychopharmacology and Biological Psychiatry
This studyshowed that phosphene threshold and resting motorthreshold are moderatelycorrelated, suggesting eithermeasure might reflect cortical excitabilityacross different brain regions However,variations in methodologyaffect the strength of this correlation, indicating furtherresearch is needed
Reischl S Ziebart C , MacDermid J C , Grewal R , Schabrun S M , Trejos A L Application of neuromuscular electrical stimulation during immobilization of extremities for musculoskeletal conditions: A scoping review Journal of Bodywork and Movement Therapies
This studyshowed that neuromuscularelectrical stimulation during immobilization can improve muscle atrophyand strength, but existing research is limited, outdated, and focused on just two musculoskeletal conditions There is a clearneed forupdated studies in broaderpatient populations to betterunderstand the potential of neuromuscularelectrical stimulation during immobilization
Wasinger V.C., Bustamante S., Najib N., Diwan A., Jayasena T., Chowdhury N.S., ..., Schabrun S. Enzymes drive glutathione shunt to explain oxidative state using an in-parallel multi-omic method. International Journal of Molecular Sciences
This studydeveloped a multi-omic method combining metabolomics and proteomics to measure glutathione shunt activityand oxidative stress Applied to inflammatory bowel disease, it offers a more accurate assessment of redox balance than traditional GSH/GSSG ratios